Specialty medicines are transforming patient outcomes across oncology, immunology, mental health and rare disease. But while innovation has accelerated, the infrastructure supporting patient access has not always kept pace. For many patients, starting and staying on therapy remains complex, often challenged by financial barriers, fragmented workflows, geographic gaps and administrative burden. 

Today’s specialty landscape demands something more resilient, more connected and more patient-centred. At Calian, we’re reimagining PSPs by taking a decentralized approach that puts patients first. 

As specialty drug spend grows and commercialization pressures intensify, manufacturers and pharmacy partners alike are recognizing the need for a more modern approach that distributes care closer to the patient without sacrificing compliance, oversight or data visibility. 

Decentralized PSPs are emerging as that model. Rather than concentrating services in a single call centre or specialty pharmacy channel, decentralized programs integrate: 

• Community pharmacies and partners  

• Real-time data integration  

• National nursing networks  

The result is a more resilient ecosystem that improves access, reduces friction and strengthens continuity of care. 

Community pharmacies: the most underleveraged assets in specialty care

Community pharmacies are among the most trusted and accessible healthcare touchpoints in Canada, going beyond what some view as simple dispensing points. Given their strong foothold in community networks and widespread availability, they’re uniquely positioned to be a central aspect of modern PSPs. In addition to dispensing specialty medicines, community pharmacists can also provide: 

• Medication education and counselling  

• Adherence support  

• Injection administration (intramuscular and subcutaneous for many specialty therapies)  

• Holistic health and lifestyle guidance  

• Home delivery and cold chain coordination  

• Coordination of benefits and financial assistance 

• Support for individuals with comorbidities or multiple prescriptions  

For patients, this translates to specialty care that is delivered close to home by professionals they already know and trust and, for manufacturers, it presents a stronger opportunity to reduce abandonment, accelerate therapy initiation and improve long-term persistence. Therapeutic relationships formed locally often translate into stronger engagement and better outcomes than traditional PSPs, making community pharmacies key players in expanding specialty care. 

Scaling access through strategic partnerships

A powerful example of this decentralized model in action is the collaboration between Calian and Walmart Canada through Walmart Pharmacy. With over 400 pharmacy locations nationwide, including 134 in rural communities, Walmart’s network places specialty access within 15 kilometres of 84 per cent of Canadians. This scale of reach represents a significant opportunity to bring specialty therapies closer to where patients live, reducing geographic barriers that have historically limited access to care. 

By leveraging an established community pharmacy network, specialty programs can expand their footprint far beyond traditional centralized distribution models. Patients gain convenient access to pharmacist-led consultations, injection services and same-day home or clinic delivery with cold chain prioritization when required. Digital prescription management tools, such as the Walmart Pharmacy app, further support adherence through refill reminders and notifications, helping patients stay on therapy and manage complex treatment regimens more effectively. 

Partnerships between PSP providers and community pharmacy networks also simplify the financial and administrative aspects of specialty care. Pharmacists can work alongside PSP teams to support reimbursement navigation and financial assistance programs, helping reduce the delays that often occur between prescription and therapy initiation. 

Collaborations like this demonstrate that decentralization of care doesn’t have to mean dilution of oversight or quality. Instead, it amplifies the reach and impact of specialty programs by leveraging trusted, existing infrastructure, while still ensuring that manufacturers maintain compliance, visibility and patient support needed to deliver successful specialty programs. 

The digital backbone: why interoperability is non-negotiable

As patient support programs expand beyond centralized hubs to include community pharmacies, nursing networks and virtual care, the ability to connect systems and share information seamlessly becomes more critical. Without a strong digital foundation, decentralization can quickly lead to fragmented workflows and limited visibility across the patient journey, introducing risk. When electronic medical records, payer systems, pharmacies and PSP platforms operate in silos, providers and program teams lack a complete view of the patient experience and are impacted by increased administrative burden in trying to reconcile data and systems.  

Calian’s proprietary Nexi platform was designed to address these challenges by enabling real-time data integration across EMRs, CRMs and reimbursement systems. By connecting these systems within a single digital environment, Nexi creates a unified view of the patient journey from prescription to therapy initiation and ongoing support, allowing key stakeholders such as prescribers the opportunity to visualize the patient journey at every step. Automated workflows reduce manual tasks, accelerate benefits verification and streamline prior authorization processes, helping patients access their medications faster while reducing administrative strain on providers and program teams. 

These digital integration efficiencies translate into operational and commercial optimization for pharmaceutical manufacturers. Therapies can be delivered faster and performance can be monitored more closely. At the same time, integrated data streams support stronger real-world evidence generation that can inform value-based payer discussions and future program design. Additionally, automated adverse event reporting workflows help ensure safety signals are captured and reported consistently, achieving a 98 per cent on-time reporting rate and reinforcing both patient safety and regulatory confidence. 

Extending care beyond the pharmacy counter

To truly power a decentralized patient support ecosystem at Calian, we rely on our national network of skilled nurses to deliver high-quality care across Canada, including in remote and rural communities. Through technology-enabled coordination, patients can be quickly connected to nurses in their vicinity and often maintain a consistent nurse relationship throughout their therapy. 

These nurses support patients through services such as blood draws, infusions and injections, injection training, and home-based care. By bringing clinical services closer to patients, nursing networks help reduce strain on clinics while making treatment more convenient and accessible.

When nursing networks, community pharmacies and digital platforms work together, the patient journey becomes coordinated and continuous—delivering care that feels seamless and personalized.

Putting it all together: a shared opportunity

For pharmaceutical commercial leaders, decentralized and digitally enabled PSPs offer a meaningful opportunity to improve both access and performance across the specialty care journey. By combining community pharmacy networks and clinical services with a digital, interoperable backbone, these programs deliver several key advantages. 

Faster time-to-therapy: Digital workflow automation streamlines critical onboarding steps such as benefits verification, prior authorization and patient enrollment. By reducing administrative delays and connecting patients directly to local pharmacy and clinical resources, decentralized PSPs help ensure patients can begin treatment sooner. 

Expanded patient access: Integrating community pharmacy networks significantly broadens the geographic reach of specialty programs. Patients can access medications, consultations and clinical services closer to home, helping overcome barriers for those in rural or underserved areas while improving overall program reach. 

Improved adherence and continuity of care: When patients receive ongoing support through trusted local pharmacies, coordinated nursing services and digital adherence tools, they are more likely to stay engaged with their treatment. This continuous support can be tailored to individual needs, helping patients manage side effects, maintain therapy and ultimately achieve better outcomes. 

Greater operational efficiency and insight: Digitally connected PSP platforms provide manufacturers with real-time visibility into program performance while reducing duplicated administrative processes across stakeholders. Integrated data also enables stronger real-world evidence generation, supporting better program optimization and payer engagement. Program design can be further enhanced by optimizing fit-for-purpose services for patients across different phases of their journey or the drug lifecycle, improving long-term financial sustainability. 

In a market where commercialization success depends on both access and outcomes, PSP infrastructure can become a true competitive differentiator and, for community pharmacies, participation in these programs creates opportunities to expand clinical services, strengthen patient relationships and integrate more deeply into specialty care delivery. Ultimately, decentralized PSPs represent a shared opportunity to improve efficiency, expand access and deliver better experiences for patients, providers and manufacturers across the healthcare ecosystem. 

The question is no longer whether decentralization is viable. We must ask ourselves: How do we build PSP infrastructure that is designed for the realities of modern specialty care, supporting patients today and in the future in an individualized, digitally enabled way? 

Learn more about how we’re reimagining PSPs for a more connected future at https://www.calian.com/health/pharma-solutions/patient-support-program-design-delivery/.